Narcotic Analgesics Opioids

Many other synthetic compounds such as dextropropoxyphene (D-propoxyphene) and methadone, for example, are potent narcotic analgesics (opioid agonists) and their use is controlled in most countries. Dextropropoxyphene is extensively metabolized by N-demethylation and by other routes. Methadone is metabolized largely by N-demethy-lation and hydroxylation. Dextropropoxyphene is thermally labile but may be measured together with nordextro-propoxyphene by HPLC with electrochemical oxidation detection methadone and some metabolites may also be measured using this same system. 

Opioid analgesics are the narcotic analgesics obtained from the opium plant. More than 20 different alkaloids are obtained from the unripe seed of the opium poppy... 

Morphine, when extracted from raw opium and treated chemically, yields the semisynthetic narcotics hydromorphone, oxymorphone, oxycodone, and heroin. Heroin is an illegal narcotic in the United States and is not used in medicine. Synthetic narcotics are those man-made analgesics with properties and actions similar to the natural opioids. Examples of synthetic narcotic analgesics are methadone, levorphanol, remifen-tanil, and meperidine Additional narcotics are listed in the Summary Drug Table Narcotic Analgesics. 

Classification of the narcotic analgesics is based on their activity at the opioid receptor sites. Although five categories of opioid receptors have been identified, only three of these receptors affect the action of the narcotic... 

The major use of the narcotic analgesic is to relieve or manage moderate to severe acute and chronic pain. The ability of a narcotic analgesic to relieve pain depends on several factors, such as the drug, the dose, the route of administration, the type of pain, the patient, and the length of time the drug has been administered. Morphine is the most widely used opioid and an effective drug for... 

Few studies have explored the efficacy of opioids specifically for OA. The APS recommends against the use of codeine and propoxyphene for OA because of the high incidence of adverse effects and limited analgesic effectiveness. Oxycodone is the most extensively studied of the agents recommended for OA. However, other narcotic analgesics such as morphine, hydromorphone, methadone, and transdermal fentanyl are also effective. 

It is worth mentioning that iV-allylic substitution in a number of morphine derivatives, as a rule, leads to antagonistic properties. Naloxone is a few times stronger than nalorphine as an antagonist. It blocks opiate receptors. It eliminates central and peripheral action of opioids, including respiratory depression. Naloxone is used upon overdose of narcotic analgesics.Synonyms for this drug are narkan, talwin, and others. 

Concomitant narcotic administration - The respiratory depressant effect of fentanyl may persist longer than the analgesic effect. Consider the total dose of all opioid analgesics used before ordering narcotic analgesics during recovery from anesthesia. Use opioids in reduced doses initially, %to 1/3 those usually recommended. 

Tramadol Acute intoxication with alcohol, hypnotics, narcotics, centrally acting analgesics, opioids, or psychotropic drugs. 

Deaths, cardiac and resp have been reported during initiation and conversion of pain pts to methadone Tx from Tx w/ other opioids Uses Severe pain detox w/ maint of narcotic addiction Action Narcotic analgesic Dose Adults. 2.5-10 mg IM q3-8h or 5-15 mg PO q8h titrate as needed Feds. 0.7 mg/kg/24 h PO or IM -s- q8h T slowly to avoid resp depression X in renal impair Caution [B/D (prolonged use/high doses at term), + (w/ doses =/> 20 mg/24 h)], severe liver Dz Disp Tabs, inj SE Resp depression, sedation, constipation, urinary retention, T QT interval, arrhythmias Interactions T Effects W/ cimetidine, CNS depressants, protease inhibitors EtOH T effects OF anticoagulants, antihistamines, barbiturates, glutethimide, methocarbamol ... 

Drugs obtained from morphine are known as opioids or narcotic analgesics. 

The narcotic analgesics are also called the opioids because they are related structurally to the natural products of the opium poppy. The medicial properties of opium have been known for thousands of years. It has been used by shamans and medicine men and women for pain, sleep, coughing, and diarrhea. The key chemical compound among the 20 or so isolated from the resin of the... 

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